Abstract
Background
Although suspected, relationships between sex steroids and bone mineral density (BMD)
are not fully defined in male population. According to recent data there may also
exist an association between low BMD and atherosclerosis.
Objective
Our aim was to investigate relationships between serum sex steroids and BMD, and between
BMD and atherosclerosis in men with coronary artery disease (CAD).
Subjects and methods
We recruited for the study 55 men aged 40–60 years with angiographically confirmed
CAD and 30 healthy, age-matched controls. In each of the examined subjects serum levels
of total testosterone (T), estradiol (E2), estrone and DHEA-S, as well as femoral neck, lumbar spine and total skeleton BMD
were measured.
Results
We found that the prevalence of osteopenia/osteoporosis recognized on spine and/or
femoral BMD (T-score below −1.0) did not differ between men with CAD and healthy controls (respectively
47% versus 47%; p = 0.8 in χ2 Yates test). The mean BMD value at different regions did not differ between both
groups either. Hormonal status of men with CAD and normal BMD was similar to men with
CAD and osteopenia/osteoporosis except for the level of testosterone. After adjustment
for age and BMI, men with lower BMD had lower testosterone and lower T/E2 ratio than men with normal BMD (geometric means for testosterone were respectively:
16.1 ± 8.3 versus 16.2 ± 4.2; p < 0.05 in ANCOVA with BMI and age as covariates; for T/E2 ratio it was: 202.1 ± 94.7 versus 222.8 ± 83.9; p = 0.05). However, we did not find any correlation between sex hormones concentrations
and bone mineral density. There was a relationship between the advance of atherosclerosis
(ranged by number of stenotic arteries) and BMD: men with the most advanced form of
the disease (three-vessels) had the lowest femoral neck BMD. The groups did not differ
in lumbar spine BMD.
Conclusions
Our data suggest that in middle-aged men with CAD: (1) lower serum testosterone and
lower T/E2 ratio are associated with lower BMD; (2) advance of coronary atherosclerosis is inversely
related to femoral neck BMD, however this relationship is weak and requires further
investigation.
Keywords
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Article info
Publication history
Accepted:
January 18,
2006
Received in revised form:
January 11,
2006
Received:
May 29,
2005
Identification
Copyright
© 2006 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
